| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KTIMEHR INSURANCE SERVICES INC.3 | 17872 COWAN IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $55K | — | $55K | 1.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $37K | $2K | $39K | 0.94% |
| KTIMEHR INSURANCE SERVICES INC.3 | 17872 COWAN IRVINE, CA 92614 | BLUE CROSS OF CALIFORNIA | $96K | — | $96K | 2.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 4047 CONCORD, CA 94524 | BLUE CROSS OF CALIFORNIA | $64K | $6K | $71K | 1.98% |
| KTIMEHR INSURANCE SERVICES INC.3 | 17872 COWAN IRVINE, CA 92614 | METROPOLITAN LIFE INSURANCE COMPANY | $46K | — | $46K | 6.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $31K | $45 | $31K | 4.67% |
| KTIMEHR INSURANCE SERVICES INC.3 | 17872 COWAN IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 1.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | $305 | $5K | 1.29% |
| KTIMEHR INSURANCE SERVICES INC.3 | 17872 COWAN IRVINE, CA 92614 | VISION SERVICE PLAN | $2K | — | $2K | 1.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | VISION SERVICE PLAN | $1K | — | $1K | 1.20% |
| KTIMEHR INSURANCE SERVICES INC.3 | 17872 COWAN IRVINE, CA 92614 | SAFEGUARD HEALTH PLANS, INC. | $6K | — | $6K | 5.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | SAFEGUARD HEALTH PLANS, INC. | $4K | — | $4K | 3.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | METLIFE LEGAL PLANS | $1K | $59 | $1K | 10.57% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 541 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 545 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 626 | $8.0M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,082 | $754K |
| Vision | VISION SERVICE PLAN | 646 | $102K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,082 | $657K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,082 | $657K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,082 | $657K |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 626 | $8.0M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,082 | $668K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,082 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.